Performing Court-Ordered Psychological Evaluations

As readers learned in previous posts, forensic psychology has many avenues. Today, we explore the role of "house" psychology professionals within the courts. Just as treatment providers encounter an unending array of presentations that keep their work interesting, so, too, do forensic evaluators. Evaluations are often complex and have the additional component of legal considerations.

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You're probably familiar with psychologists being cross-examined on the stand. Such is the life of expert witnesses and private evaluators hired by attorneys hoping for specific outcomes. However, did you know that most courts have Court Clinics, built-in psychological evaluation services? Practitioners are usually psychologists, master's level clinicians, and sometimes psychiatrists.

In adult courts, the work is primarily that of psychologists performing a few different types of evaluations:

Competency to stand trial

These evaluations examine the defendant's ability to understand the charges against them and the proceedings of the court. Competence is important because defendants need to be informed participants in their defense. If attorneys or judges believe a defendant may have a psychological illness or defects inhibiting their ability to understand proceedings, they can request such an evaluation. Court psychologists may attend to the individual in a court-based office, or, if they are detained, in a facility.

Jurisdictional criteria and case law set criteria for competence. In Massachusetts, the definition of competence is whether the defendant has sufficient present ability to consult with their lawyer with a reasonable degree of rational understanding. It also includes whether they have a rational as well as factual understanding of the proceedings.

Competence evaluations examine not only mental status, but explore various judicial items with defendants. These include processing and reasoning abilities around items such as the nature of a charge or what it could mean to accept a guilty plea versus going to trial. If competent, the defendant reappears in court and proceedings continue. If found incompetent, a case might be put on hold until competency is restored. Restoration requires stabilization/educating the defendant about proceedings. However a person is found, the clinician may be required to provide testimony, but that is not a given, like in the next evaluations.

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Criminal responsibility

Responsibility evaluations concern determining whether an accused individual was influenced by a mental defect such that:

• They were unable to appreciate the wrongfulness of the unlawful activity, or
• They were unable to make themselves behave lawfully

As readers may imagine, depending on the gravity of the charges, much is at stake and there may be a push for an insanity defense. It is important to remember, however, that just because someone has a mental illness does not mean they are unable to tell right from wrong. Examiners may spend a lot of time determining if someone is malingering or faking impairment for the desired outcome.

If motive, intent, and planning for the alleged crime can be established, a not guilty by reason of insanity (NGRI) defense is usually moot. In fact, a survey of NGRI statistics shows a trend that less than one percent of cases with this defense is successful. Some cases get interesting, for example, where motive, etc, are established, but the person was influenced by psychosis.

Emergency substance abuse and psychiatric crisis evaluations

With the flux of the opiate epidemic, some states had an increase in petitioning for involuntary commitment to substance abuse treatment. In Massachusetts, the number of filings nearly doubled between 2010 and 2018. Since such commitment requires a court petition, it makes sense that Court Clinic personnel perform the evaluation.

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While this is a civil matter, if the individual refuses to come to court, an arrest warrant may be issued given the potential danger the person poses to themselves or others. For commitment, an examiner must find the person dangerous to themselves and/or others because of the effects of substances. Attorneys can challenge findings and examiners may find themselves badgered on the stand like any expert witness. Ultimately, it is not the examiner's role to ensure the person gets committed. They simply explain to the court their professional opinion, and it is up to the judge. This is true in both adult and juvenile courts.

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Psychiatric crisis evaluations are requested when someone presents acute mental health problems within the court. A risk assessment is performed by a Court Clinician, and if deemed at risk, just like in a community setting, they may are hospitalized.

Seeking opportunities

If you are in a doctoral or psychiatry program and the above piques your interest, locating internships or post-doctoral fellowships in courthouses will lay a good foundation. Should you be a master's level practitioner and want to work in a Court Clinic, don't fret! In the next post, we'll compare adult and Juvenile Court Clinicians' work.